Organization
RENAISSANCE RECOVERY SERVICES, LLC
Active
Other names
Renaissance Malibu
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SALVATORE PETRUCCI (PRESIDENT)
(818) 707-8102
Entity
Organization
Contact information
Practice address
30101 AGOURA CT LBBY 3, AGOURA HILLS, CA 91301-4300
(818) 707-8102
(818) 707-8111
Mailing address
30765 PACIFIC COAST HWY # 356, MALIBU, CA 90265-3646
(818) 707-8102
(818) 707-8111
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190392AP
CA
324500000X
Substance Abuse Rehabilitation Facility
190392BP
CA
Other
Enumeration date
09/04/2008
Last updated
09/04/2008
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